Case Study Reflection on Patient with Myocardial Ischemia
Verified
Added on 2023/06/13
|4
|774
|403
AI Summary
This case study reflection discusses the treatment of a patient with myocardial ischemia after angioplasty surgery. The patient's medical history, vitals, and treatment options are discussed in detail.
Contribute Materials
Your contribution can guide someone’s learning journey. Share your
documents today.
Running head: REFLECTION SIMULATION Case Study Reflection Name of Student Name of University Author Note
Secure Best Marks with AI Grader
Need help grading? Try our AI Grader for instant feedback on your assignments.
1REFLECTION SIMULATION Reporting During my practical, I was a part of the simulation for a patient Mr. Harry Bright, who was admitted to my ward after angioplasty surgery. He had a history of unstable angina and reported chest pain. The patient is a 65-year-old male who has a medical history of hypertension forovertenyears,typetwodiabetes,whichisproperlycontrolledusingdietand hypercholesterolemia, for which he takes drugs. After the surgery monitoring showed that, the patient had developed myocardial ischemia. The sheath was removed and nitroglycerine was given to him to relax his cardiac muscles and calm the chest ache. The patient smokes twenty cigarette sticks per day (Boerma et al., 2010). Responding I found that theblood pressure is 150/90mmHg, which is quite high. The temperature of the patient is normal and the dissolved oxygen level is 98%, for thatI hadnothing to worry. The blood glucose level was 10.7mmol/L. the patient’s height was 175cm, the weight was 100 kg, whichI thought reflectedthat the person is obese according to his BMI report, which is 37. The chest x-ray report showed that the patient is having obstructive air entry. I did not observer any crepes or crackles in the lungs. Relating I checked the vitals, which showed he needed pain management and we provided him with nitroglycerine to reduce the pain score (Boerma et al., 2010). The patient showed hypertensive conditions for which I provided metropol for reducing chest pain and increase blood circulation. I advised to patient to take metformin for dieting and controlling his weight. I advised the patient
2REFLECTION SIMULATION to continue his warfarin dose for controlling his hypercholesterolemia (Patel et al., 2011). Simvastati was also suggested to the patient to control his weight; I think should be admitted in the hospital and commence a full blood count, electrolyte and urinalysis, blood coagulation checkup and ECG (Peyronnet et al., 2014). I took care for the patient to monitor his PTCI pathway to prevent and further complication. Reasoning Hypercholesterolemia causes the elevation of heart rate by blocking the cardiac passageway by fatdeposition.ThisiswayIprovidedbeta-blockersandhyperglycemias.Nitroglycerine smoothens the cardiac muscle by activating the nitrogen oxide which relaxes the smooth muscle, this is why my superior administered the NG to reduce angina and heart blockage. Reconstructing From this I learned that it is important to monitor the patient very closely after PACU, as further complication can arise from a surgery like in this case when the ;patient developed myocardial ischemia (Illuminati et al., 2010). I would advise the patient to control his diet and take his medicines properly everyday to reduce repercussion of the congenital diseases.
3REFLECTION SIMULATION References: Boerma, E. C., Koopmans, M., Konijn, A., Kaiferova, K., Bakker, A. J., van Roon, E. N., ... & Koetsier, P. M. (2010). Effects of nitroglycerin on sublingual microcirculatory blood flow in patients with severe sepsis/septic shock after a strict resuscitation protocol: a double-blind randomized placebo controlled trial.Critical care medicine,38(1), 93-100. Illuminati, G., et al. "Systematic preoperative coronary angiography and stenting improves postoperative results of carotid endarterectomy in patients with asymptomatic coronary arterydisease:arandomisedcontrolledtrial."EuropeanJournalofVascularand Endovascular Surgery39.2 (2010): 139-145. Patel, M. R., Mahaffey, K. W., Garg, J., Pan, G., Singer, D. E., Hacke, W., ... & Becker, R. C. (2011). Rivaroxaban versus warfarin in nonvalvular atrial fibrillation.New England Journal of Medicine,365(10), 883-891. Peyronnet, B., Baumert, H., Mathieu, R., Masson‐Lecomte, A., Grassano, Y., Roumiguié, M., ... & Taille, A. (2014). Early unclamping technique during robot‐assisted laparoscopic partial nephrectomy can minimise warm ischaemia without increasing morbidity.BJU international,114(5), 741-747.